This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Butler, J. Search for Related Content PubMed PubMed Citation Articles by Butler, J.

Circulation, Vol 67, 1163-1168, Copyright © 1983 by American Heart Association

ARTICLES

The heart is in good hands

J Butler

A review of mechanical cardiopulmonary interactions is presented and some extrapolations are made concerning cardiopulmonary resuscitation, with the following conclusions: (1) The cardiac fossa of the lungs provides a soft heart bed at normal lung volumes, but tenses at higher volumes to improve the support of the heart during postural changes. (2) The cardiac fossa is a physiologic constraint at normal heart volumes. It acts to restrict ventricular expansion before there is pericardial restriction. The physiologically useful interventricular interdependence is thereby promoted. (3) The effect of lung inflation in tensing the walls of the fossa may also sometimes embarrass both ventricles. Together with the raised intrathoracic pressure, it is responsible for the fall in left and right ventricular volumes and output during positive pressure ventilation. (4) New techniques of cardiopulmonary resuscitation depend on repeated, abrupt increases in pressure in both chest and abdomen, as in coughing.

This article has been cited by other articles:

				G.-C. Funk, I. Lang, P. Schenk, A. Valipour, S. Hartl, and O. C. Burghuber Left Ventricular Diastolic Dysfunction in Patients With COPD in the Presence and Absence of Elevated Pulmonary Arterial Pressure Chest, June 1, 2008; 133(6): 1354 - 1359. [Abstract] [Full Text] [PDF]

				S. Magder and F. Bafaqeeh The Clinical Role of Central Venous Pressure Measurements J Intensive Care Med, January 1, 2007; 22(1): 44 - 51. [Abstract] [PDF]

				M. R. Pinsky Cardiovascular Issues in Respiratory Care Chest, November 1, 2005; 128(5_suppl_2): 592S - 597S. [Abstract] [Full Text] [PDF]

				P. Palermo, G. Cattadori, M. Bussotti, A. Apostolo, M. Contini, and P. Agostoni Lateral Decubitus Position Generates Discomfort and Worsens Lung Function in Chronic Heart Failure Chest, September 1, 2005; 128(3): 1511 - 1516. [Abstract] [Full Text] [PDF]

				N. Stocchetti, A. I.R. Maas, A. Chieregato, and A. A. van der Plas Hyperventilation in Head Injury: A Review Chest, May 1, 2005; 127(5): 1812 - 1827. [Abstract] [Full Text] [PDF]

				J.-C. Fauchere, A. M. Walker, E. M. Skuza, and D. A. Grant Right atrial pressure as measure of ventricular constraint in newborn lambs Am J Physiol Heart Circ Physiol, June 1, 2001; 280(6): H2740 - H2745. [Abstract] [Full Text] [PDF]

				D. A Grant, A. M Walker, and J.-C. Fauchere Age-related differences in the distortion of the sheep lung in response to localised pleural stress J. Physiol., January 1, 2001; 530(1): 153 - 160. [Abstract] [Full Text] [PDF]

				R. Ramos, B. I. Salem, M. P. DePawlikowski, M. Tariq, M. Haikal, T. Pohlman, and P. Mennes Outcome Predictors of Ultrafiltration in Patients with Refractory Congestive Heart Failure and Renal Failure Angiology, May 1, 1996; 47(5): 447 - 454. [Abstract] [PDF]

				J. N. Amoore and W. P. Santamore A Simulation Study of Factors Influencing Respiratory Variations in Blood Flow with Special Reference to the Effects of the Phase Delay Between the Respiratory and Cardiac Cycles SIMULATION, April 1, 1996; 66(4): 229 - 241. [Abstract] [PDF]